New Technology Targets Ways to Reduce Ambulance Response Time in N.M.

ALBUQUERQUE, N.M. -- To the untrained eye, the graph projected on the wall in Albuquerque Ambulance Service headquarters looks like a jumble of acronyms and multi-colored lines.

To Kurt Krumperman, executive director of Albuquerque Ambulance Service, it looks like success.

Last summer, Albuquerque Ambulance, a nonprofit service and division of Presbyterian Hospital, installed new software called RescueNet Dispatch Pro that helps staff predict exactly where ambulances should be placed at any hour.

Last month, they added another component that determines exactly which route ambulances took to a call - and what might have been a better way.

The new technology, along with a new way to analyze data, has dramatically reduced the time it takes to respond to emergency calls.

Before the changes, ambulances responded to priority 1, or life- threatening calls, within 10 minutes between 86 percent and 88 percent of the time, says Heath Wright, system status director for Albuquerque Ambulance Service.

They now respond within that time frame about 96 percent of the time. The goal is at least 92 percent. They try to make nonlifethreatening calls in 15 minutes.

Albuquerque Ambulance Service already used RescueNet Dispatch, also made by Massachusettsbased company ZOLL Medical Corp., but the added software brings existing data together in a set of easy "vital signs," Krumperman says.

"It's able to bring together a number of pieces of information that exist in our database," he says. "This software enables us to use all that data in the moment."

To complement the new technology, department heads gather Monday through Friday for a meeting they call PULSE, when they review details from the day before like late calls and staffing needs. (PULSE stands for performance, utilization, late response review, system analysis and exceptions, events and excellence.)

"Most of the departments in this room should be able to look at this and be able to tell, really quickly, what happened yesterday," Wright says, pointing to the graph.

At the meetings, staff review each call that didn't meet response goals. As soon as they get a call, crews should move within 60 seconds. If they take longer, that is a problem.

PULSE meetings are open to anyone, including the public, but space is limited.

At a Monday meeting in February, William O'Neal, communication center manager for Albuquerque Ambulance Service, described 14 calls from the previous three days.

In one, a call came from the East Mountains and the ambulance couldn't cover the distance fast enough. In another, paramedics didn't hear the radio.

"That's a problem we've got to fix," says Krumperman.

Others involve callers who use the wrong quadrant to describe a location or inaccurate GPS directions.

About 500 ambulance and fire companies around the country use RescueNet Dispatch and 82 use the Pro feature, according to ZOLL.

The idea for daily meetings came from a successful ambulance outfit in Pinellas County, Florida, that also uses ZOLL software, Krumperman says. After Wright was sent to check out their approach, he was sold. Staff used to gather about once a week to review metrics. In September, they added daily meetings.

"(Wright) was so impressed," Krumperman says. "He came back and said, 'We need to do this here.' It really got everyone focused."

The goal is to use data to balance staff wellness and customer satisfaction while cutting costs, Wright says.

For example, seeing how many calls come in and how many people are on duty helps guide decisions about when overtime is needed.

They often learn most from mistakes, Krumperman says.

"The approach is a continuous learning environment," he says.

At each meeting, staff plan for big events - like snow storms that bring skiers to the slopes or the Super Bowl.

The day after the Super Bowl, they looked back at Sunday's numbers.

"Our call volume is up for a Sunday," Krumperman says, checking out the graph.

But calls didn't coincide with the end of the game.

"It ended up being a nonevent," O'Neal says.

While staff members easily throw around statistics, the maze of numbers and acronyms at a PULSE meeting can be confusing.

"Saturday is a 4.3," Wright says at one meeting. "That is too high of a UHU."

In layman's terms? The stats predict more calls than staff can handle that day.

One of the biggest changes is actually in the dispatch room. Here, dispatchers sit in front of multiple screens. On a wall in front of them, a digital "hot zone" map shows areas they can expect to get calls based on previous years.

On a recent Wednesday afternoon, the hottest zone - in bright purple - was the Paseo del Norte exchange on I-25. To come up with that analysis, software tracked Wednesday afternoons in February and March for the past five years. In other areas, the map shows gray pockets where calls are less likely.

To meet expected needs, dispatchers strategically place on-duty ambulances. As the map changes through the day, dispatchers alert drivers.

That means that ambulance in the Starbucks parking lot may be there for a reason.

The map also shows how much terrain ambulances can cover - on this day, 28 trucks can reach 98 percent of the coverage area.

Inside ambulances, paramedics and emergency medical technicians use touch screens to map locations but they do not have an effective GPS system to figure out the best routes.

Albuquerque Ambulance Service is planning an upgrade so drivers use the same system as dispatchers. That upgrade, expected later this year, will cost about $190,000, Wright says.

How 911 calls work

When a 911 call comes in from Albuquerque, Bernalillo County or Corrales, it first goes to the appropriate fire department. If it is a request for any kind of emergency medical service, it will also go to Albuquerque Ambulance dispatchers. In both the city and the county, a request for emergency medical help will get fire and ambulance response. AAS: vital stats

About 210-220 transports per day in Albuquerque, Corrales and Bernalillo County (including hospital transports)